Department of Orthopedics, The Second Affiliated Hospital of Soochow University, No.1055, SanXiang Road, Gusu District, Suzhou, Jiangsu Province, 215004, PR China.
Department of Radiology, The Second Affiliated Hospital of Soochow University, No.1055, SanXiang Road, Gusu District, Suzhou, 215004, China.
BMC Musculoskelet Disord. 2023 Aug 2;24(1):625. doi: 10.1186/s12891-023-06764-5.
The risks associated with deep vein thrombosis (DVT) have gained significant recognition over time. A prevalent form of distal DVT is isolated calf muscular venous thrombosis (ICMVT). Despite its common clinical occurrence, data on ICMVT subsequent to tibial plateau fracture (TPF) surgery are scarce. This study aimed to examine the epidemiological characteristics and associated risk factors (RFs) of ICMVT following TPF surgery.
For this retrospective analysis, we included patients from our hospital, who underwent TPF surgery between March 2017 and March 2021. Patients' electronic medical records were reviewed, including admission details, fracture classification, surgical procedures, and laboratory biomarkers. The HSS (The American Hospital for Special Surgery) and Rasmussen scores were employed to evaluate the clinical effect. A Color Duplex Flow Imager (CDFI) was regularly used to detect pre- and postoperative venous thrombosis in the lower limbs. Finally, uni- and multivariate logistic regression analyses were used to identify independent RFs associated with ICMVT.
Overall, 481 participants were recruited for analysis. Postoperative ICMVT occurred in 47 patients. All ICMVTs occurred on the affected side. Four of the 47 ICMVT patients exhibited sudden postoperative swelling in the affected limb. The HSS and Rasmussen scores in the non-ICMVT cohort (87.6 ± 8.2, 16.0 ± 1.7) were markedly different from the ICMVT cohort (84.8 ± 8.2, 15.5 ± 1.6) (p = 0.014, p = 0.031). This study finally identified five postoperative ICMVT-related RFs, which were age (> 55 years old) (OR 3.06; 95% CI 1.47-6.37; p = 0.003), gender (female) (OR 2.67; 95% CI 1.37-5.22; p = 0.004), surgical duration (> 114 min) (OR 3.14; 95% CI 1.44-6.85; p = 0.004), elevated white blood cell content (OR 2.85; 95% CI 1.47-5.51; p = 0.002), and hyponatremia (OR 2.31; 95% CI 1.04-5.12; p = 0.040).
The epidemiological findings of this study may help predict ICMVT risk after surgery thus facilitating the development of individualized clinical assessments and targeted prevention programs.
深静脉血栓（DVT）相关风险已随着时间推移而得到广泛认识。一种常见的远端 DVT 形式是孤立性小腿肌间静脉血栓形成（ICMVT）。尽管其在临床上较为常见，但关于胫骨平台骨折（TPF）术后 ICMVT 的数据却很少。本研究旨在研究 TPF 手术后 ICMVT 的流行病学特征和相关风险因素（RFs）。
本回顾性分析纳入了 2017 年 3 月至 2021 年 3 月期间在我院接受 TPF 手术的患者。对患者的电子病历进行了回顾，包括入院详细信息、骨折分类、手术过程和实验室生物标志物。采用 HSS（美国特种外科医院）和 Rasmussen 评分评估临床效果。常规使用彩色双功能超声血流成像仪（CDFI）检测下肢术前和术后的静脉血栓形成。最后，采用单因素和多因素逻辑回归分析确定与 ICMVT 相关的独立 RFs。
共纳入 481 名参与者进行分析。术后发生 ICMVT 的患者有 47 例。所有 ICMVT 均发生在患侧。47 例 ICMVT 患者中有 4 例在术后出现患侧肢体突然肿胀。非 ICMVT 组的 HSS 和 Rasmussen 评分（87.6±8.2、16.0±1.7）与 ICMVT 组（84.8±8.2、15.5±1.6）有显著差异（p=0.014，p=0.031）。本研究最终确定了五个与术后 ICMVT 相关的 RFs，即年龄（>55 岁）（OR 3.06；95%CI 1.47-6.37；p=0.003）、性别（女性）（OR 2.67；95%CI 1.37-5.22；p=0.004）、手术时间（>114 分钟）（OR 3.14；95%CI 1.44-6.85；p=0.004）、白细胞含量升高（OR 2.85；95%CI 1.47-5.51；p=0.002）和低钠血症（OR 2.31；95%CI 1.04-5.12；p=0.040）。
本研究的流行病学发现可能有助于预测术后 ICMVT 风险，从而有助于制定个体化临床评估和针对性预防计划。
